Special Circumstances Request - Dependency Override

Form PJ215

Revised: October 28, 2020Page 1 of 1

Return Completed Form To:Office of Student Financial Aid 220 Holmes/Hunter Academic Building Athens, Georgia 30602-6114 Fax: (706) 542-8217

Student's UGA ID

81

Student's Telephone Number

Student's Full Name

POLICY: Federal regulations allow limited exceptions or adjustments to information reported on the Free Application for Federal Student Aid (FAFSA). Such exceptions or adjustments, known as "Special Circumstances" or "Professional Judgment," are considered on an annual case by case basis based on supporting documentation of the situation and available income/assets. Whether any adjustments are made is at the sole discretion of the Office of Student Financial Aid (OSFA), and cannot be appealed beyond OSFA. OSFA will review and process one request for a student per academic year. PROCEDURE: This form is an "in-take" form for OSFA to screen your Special Circumstances request for the academic year (do not submit supporting documentation at this time). OSFA will respond to this request within 5 business days. If this request is permissible, you will be notified to submit supporting documentation through the OSFA Secure Portal. Special Circumstance processing can take up to 2 weeks once all supporting documentation is received (note that during peak processing times [i.e., June through September] processing can take up to 4 weeks).

DIRECTIONS: 1. Complete this form by selecting the Special Circumstances type(s) below and signing/dating the form 2. Attach a student signed/dated statement detailing the Special Circumstances (include your UGA Student ID [81XXXXXXX]) 3. Submit form and student signed/dated statement to OSFA

By submitting this form, I acknowledge that I will comply timely with requests from UGA's Office of Student Financial Aid (OSFA) for additional supporting documentation. I further acknowledge the review of and final decision on my request is solely at the discretion of OSFA, and cannot be appealed beyond OSFA. If approved, I further acknowledge OSFA staff will transmit changes to my FAFSA to the federal processor. I attest and certify that the information provided during this process (including this form, any written statement, additional information, and/or supporting documentation provided by me or on my behalf) is a true, complete, and accurate representation of my circumstances. I acknowledge that purposely providing false or misleading information during this process (including this form, any written statement, additional information, and/or supporting documentation provided by me or on my behalf), may subject me to university sanction, loss of student financial aid, and/or criminal penalty and/or fine(s).

DateStudent's Signature

Dependency Override > Initial Request (first time submitted to OSFA) l Dependency Override Circumstances that may be considered: cases of parental abuse, neglect, abandonment, or incarceration l Dependency Override Circumstances that cannot be considered: parent refusal to provide information on the FAFSA (students under the age of 24 are typically considered dependents and require parent information on the FAFSA); parent refusal to provide financial support; student being financially self-sufficient l Student Signed Statement must include the following: detailed and dated description of the situation; explanation of why you believe you should be considered independent; the last time and circumstances under which you had contact with your parent(s); explanation how you support yourself (including all sources of income and support) l Future Supporting Documentation Requests may include: official court documents; two supporting letters of documentation from objective individuals with first-hand/direct knowledge of the situation (i.e. individuals who are not relatives or friends)

Dependency Override > Renewal (approved by OSFA in previous academic years) l Student Signed Statement must include the following: detailed and dated description of your existing situation; explanation stating if circumstances are the same or if they have changed since your initial request for a dependency override; explanation how you support yourself (including all sources of income and support)